An intermediate-level coding class that incorporates hands-on practice in the assignment of insurance codes using case studies and medical record simulations. Presents theory and practice of coding diseases and procedures using International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) for inpatient facilities. Explores the Prospective Payment System (PPS) and the significance of Diagnosis Related Groupings (DRG). This course utilizes electronic and paper-based medical documentation to serve as resources for coding for inpatient reimbursement, and the application of all federal laws related to patient health information in the process of medical business practices.
Goals, Topics, and Objectives
- Medical Documentation
- Principles of Confidentiality of Medical Records
- Coding Procedures, Signs, Symptoms
- Basics of Coding to ICD-10-CM
- Coding According to Body Systems
- The Prospective Payment System
- Coding for Obstetrical Conditions
- Coding for Cardiovascular Conditions
- Coding for Neoplasm
- Coding for Injuries
- Coding for Adverse Effects and Poisoning
- V Coding and E Coding
- Coding for Medical Complications
- Apply the principles of coding according to ICD-10-CM for inpatient reimbursement.
- Identify key items that require code assignment from the medical documentation and apply the correct codes.
- Apply the principles of selection diagnoses and principle procedure code selection along with complications and co-morbidities.
- Group coded items using existing software to arrive at the correct Diagnosis Related Grouping (DRG) and therefore optimum reimbursement for a given medical case study.
- Explain the importance of the principles of confidentiality of medical information to include federal and state regulations.
- Identify key contributing factor of a medical chart and explain the meaning behind it.
- Explain the guidelines associated with each chapter of the ICD-10-CM.
- Identify principle diagnoses and reason for the visit, and know the difference.
- Explain present on admission (POA).
- Perform coding procedures using legal and ethical standards of the profession.
Assessment and Requirements
Assessment of academic achievement will include participation, assignments, examinations and final exam.
Assessment activities will use the following weighted percentages:
Although not a prerequisite, it is highly recommended that students take BIO 134 (Essentials of Anatomy and Physiology) prior to taking HIT 150. This information is the required knowledge necessary to code procedures and diagnostic statements using the ICD-10CM/ Current Procedural Terminology (CPT) coding system and to improve success on the national board exam certification examination.
- Make-up exam policy: The student will arrange to make up any missed examinations at the convenience of the instructor, to be completed before the next class session.
- Attendance: Student attendance is required for each class. Class will consist of application exercises and discussion along with computer laboratory exercises. These experiences cannot be made up.
- Although students are encouraged to discuss coding homework as a learning exercise, students will not furnish answers to classmates who have not done their homework.
- If a student misses a class meeting, it is his/her responsibility to gather needed materials and information.
- A student who is considering withdrawal from this course they should speak with the instructor first and follow the guidelines established in the HFC catalog.
Required textbooks to be determined through departmental approval.
Credit for Prior College-Level Learning
CPC certification must be current. Department faculty will verify certification.